Carrier Load Confirmation Drop files here or Have a pre-existing document that has all/most of this information included in it already? Upload it here, and click the submit button at the bottom of the form:Pickup:Pickup Date: Premier Handling Solutions 1500 Scottsdale Court, Elgin, Illinois 60123Dock B Mon-Fri: 8:00 am - 5:00 pmWarehouse Contact Name:PHS Representative:PHS Rep. Direct Phone:Ext:PHS Rep. Email Product Information:Product:Product Value:NOTE: Carrier will cover full value of product cost of any mishap.Dimensions:(L) x(W) x(H)Loading Instructions:Unloading Instructions:DeliveryMust Deliver By: Company Name:Email Delivery Address: Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Name: First Last Contact Direct Phone:Ext:Contact Email: Company Hours:Delivery Instructions:Rate Agreed:Date Agreed: PHS Representative SignatureCarrier Representative SignatureName:Driver Name:Phone:Driver Cell Number:Carrier acknowledges receipt of packages and required placards. Carrier certifies emergency response information was made available and/or carrier has the DOT emergency response guidebook or equivalent documentation in the vehicle. Property described above is received in good order, except as noted.CAPTCHASecurity Code This iframe contains the logic required to handle Ajax powered Gravity Forms.